The respiratory system may be divided in the upper and lower tract and includes the nostrils, nasal passage, guttural pouches, sinuses, pharynx, larynx (throat) , trachea (windpipe), bronchii and bronchioles (small airways) and lungs. Clinical signs and the type of work up required depends on where the problem is likely to be located.
Full assessment of these problems are available using digital endoscopy; respiratory fluid sampling; ultrasonography and radiography where necessary. For horses exhibiting respiratory problems during exercise we can arrange overground endoscopy which allows us to assess the pharynx and larynx dynamically during work, typically on the gallops at Lingfield Park. We also work closely with world renowned soft tissue surgeon Safia Barakzai providing your horse with world class treatment should this be required.
We aim to provide you with the most current treatment therapies available. Medical treatments for respiratory conditions can be challenging to administer and/or require expensive equipment. To ensure all our clients and patients have access to the best level of care we can provide, we have invested in equipment such as the Flexineb inhaler and nebuliser and are happy to hire this out should it be appropriate. Please contact us to discuss this or anything else in more detail.
Cardiac abnormalities fall into two categories:
- irregular heart rhythms (arrhythmias); or
- abnormal heart noises (murmurs).
Both arrhythmias and murmurs can be classified as either those which are considered to be a variation of normal (physiological); or those which represent a clinical problem (pathological). Signs associated with heart disease include poor performance; tiring quickly at exercise (hitting a wall); prolonged recovery from exercise; generalised lethargy; swelling between the front legs.
The first step in cardiac evaluation is auscultation - using a stethoscope to carefully listen to the heart rate and rhythm, and identify any possible abnormalities. Based on this it is possible to characterise any abnormalities and assess whether further evaluation is required. Investigations into cardiac problems may be performed using one or more of the following techniques.
- Electrocardiography (ECG). This technique is used to assess arrhythmias and may be done whilst the horse is at rest, often over a 24hr period; and at exercise for a complete evaluation.
- Blood testing for specific cardiac markers.
- Echocardiography (heart scan). Ultrasonography of the heart is used to examine the heart structures, sizes shape and is particularly useful where heart murmurs are detected.
All of these tests may be undertaken at your yard or another appropriate site, such as Lingfield Park (exercising ECGs); or at our clinic in Felbridge. We have three RCVS Advanced Veterinary Practitioners in Equine Medicine, including a Diploma holder working at Lingfield Equine Vets; however, in particularly challenging cases we work closely with prominent equine cardiology Dr Lesley Young to your horse is provided with the very best level of care.
EGUS is a collective term for two distinctly different diseases affecting the same structure, the stomach. This is incredibly clever and complex structure has two separate halves - the upper squamous portion and the lower glandular portion. The degree of acidity increases towards the bottom of the stomach, thus it follow that the glandular part of the stomach is far more resilient against acid damage than the squamous part. It also makes sense that ulceration affected the squamous regions (Equine Squamous Gastric Ulceration Syndrome: ESGUS) occurs due to acid splashing, commonly at exercise and associated with high concentrate, low fibre diets. Likewise, ulceration affecting the glandular regions (Equine Glandular Gastric Ulceration Syndrome: EGGUS) occurs due to failures in the normally robust and effective defence mechanisms to cope with acid exposure.
Both disease processes can result in similar clinical presentations and signs commonly reported by owners include poor performance; dull coat; aggression around eating; reduced appetite; girthing pain; resentment of rugging or tacking up; recurrent (often mild) colic; change in temperament. Similarly, both syndromes can be diagnosed using the same technique - gastroscopy. Gastroscopy is the use of a flexible 3m endoscope to look at the inside of the stomach lining. By doing so we are able to assess the identify the presence, extent, severity and location of ulceration. Where needed it is also possible to perform biopsies of the stomach lining or ulcer beds. As with all of our diagnostics, this can be performed at your yard or at our clinic. Your horse or pony must be starved for at least 16 hours (overnight) prior to the procedure, so often clients find this more convenient at the clinic to minimise the stress at breakfast time. We will happily hospitalise your horse or pony the night before the gastroscopy the following morning to minimise stress around morning feeding on the yard and avoid you travelling your anxious, hungry horse.
There are several medications involved in the management of EGUS and these are adjusted depending on the extent, severity and location of the ulcers, specifically whether the horse is suffering from ESGUS, EGGUS or both syndromes. Squamous ulcers tend to form and heal faster than glandular ones; but it is not uncommon for a horse to be suffering to a different extent in both locations.
Your vet will discuss any abnormal findings with you and then create a bespoke management plan; not just regarding recommended medications, but reviewing the horse or pony's management, work load and exercise regime to provide you with an holistic approach to this troublesome disease.
We regularly run gastroscopy clinics and discounted fees may apply. If you have any questions, require advice about EGUS or which to enquire about an upcoming gastroscopy clinic, please contact us.